Individual
LAUREL MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LDN, CDE
Contact information
Practice address
628 E 12TH ST, WASHINGTON, NC 27889-3409
(252) 948-4933
Mailing address
628 E 12TH ST, WASHINGTON, NC 27889-3409
(252) 948-4933
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L002341
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
713933
COMMISSION ON DIETETICS REGISTRATION
NC
01
—
L002341
NC BOARD OF DIETETICS/NUTRITION
NC
Enumeration date
09/16/2014
Last updated
09/16/2014
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